MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 1495
Change Report (if Any):

Short Name: FAM SOL-SUMM

Long Name 1: FAMILY SOLUTIONS
Long Name 2:

Address 1: 2100 FRONT STREET
Address 2:

City: CUYAHOGA FALLS
Zip Code: 44221
County: SUMM

Contact: JANICE PIERSON
Title: EXDIR
Phone: 3309281159
FAX: 3309282191

Vendor: 1495

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016